The invention relates to the field of treatment of sequelae of psychiatric disorders.
Obesity has reached pandemic proportions, and it is rapidly surpassing smoking as the number one killer in the industrialized world. Its annual cost to American society is staggering and is estimated to be around $117 billion due to related illnesses and loss of productivity.
In schizophrenia, obesity is twice as prevalent as in the general public, afflicting over half the patient population. Besides negative psychosocial impacts (e.g., distorted self-esteem and societal stigmatization) and medications noncompliance, schizophrenics appear to be particularly susceptible to the detrimental medical sequelae of obesity such as the Metabolic Syndrome or a cluster of cardiovascular risk factors, including abdominal adiposity, insulin resistance, impaired glucose tolerance, dyslipidaemia, and hypertension.
As documented in historical observations prior to the advent of antipsychotic agents, schizophrenia per se is associated with increased risk for obesity. The mechanisms of obesity in schizophrenia are not fully elucidated and could result from increased caloric intake, decreased energy expenditure owing to reduced physical activity, or a combination of both. Excessive caloric supply seems to play a major role, though, as schizophrenics tend to overconsume palatable ‘junk’ food, rich in sugar and saturated fat, that produces a substantial amount of body weight gain. These unhealthy eating habits ostensibly reflect illness' neuropathology, rather than patients' inability to afford healthier food choices, as they predict poor prognosis, including increased length of hospitalizations and deteriorated social functioning.
Administration of second generation antipsychotic agents (SGAs), such as clozapine, olanzapine, and to lesser degree quetiapine and risperidone, but not ziprasidone or aripiprazole, further worsens body weight gain problems mainly due to amplified and potentially insatiable appetite leading to increased consumption of the previously preferred diet.
Accordingly, there is a need for treatments of schizophrenia, and other psychiatric disorders, that reduce detrimental sequelae.